<%@ page language="java" contentType="text/html; charset=UTF-8"
	pageEncoding="UTF-8"%>
<%@ taglib uri="http://java.sun.com/jsp/jstl/core" prefix="c"%>
<%
	String path = request.getContextPath();
	String basePath = request.getScheme() + "://" + request.getServerName() + ":" + request.getServerPort()
			+ path + "/";
%>
<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<base href="<%=basePath%>">
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta http-equiv="pragma" content="no-cache">
<meta http-equiv="Cache-Control"
	content="no-cache,no-store,must-revalidate">
<meta http-equiv="expires" content="0">
<meta name="viewport"
	content="width=device-width, initial-scale=1, maximum-scale=1, minimum-scale=1, user-scalable=no, minimal-ui">
<meta content="yes" name="apple-mobile-web-app-capable">
<meta content="black" name="apple-mobile-web-app-status-bar-style">
<meta content="telephone=no" name="format-detection">
<meta content="email=no" name="format-detection">
<title>投保申请</title>
<meta name="viewport" content="initial-scale=1, maximum-scale=1">
<link rel="stylesheet"
	href="//g.alicdn.com/msui/sm/0.6.2/css/sm.min.css">
<link rel="stylesheet" href="assets/css/rz.css">

</head>
<body>
	<div class="page-group">
		<div class="page page-current" id="index">
			<header class="bar bar-nav">
			<h1 class='title'>投保申请</h1>
			<a href="promotion/promotionDetail" id="back"
				class="button button-link button-nav pull-left back" external> <span
				class="icon icon-left"></span> 返回
			</a> </header>

			<div class="content">
				<form name="policy" action="promotion/buy2Finish" method="post">

					<div class="card" id="personalInfo">
						<div class="card-header">
							<b>2.请完善投保人其他信息</b>
						</div>
						<div class="card-content">
							<div class="list-block">
								<ul>
									<li>
										<div class="item-content">
											<div class="item-media">
												<i class="icon icon-form-password"></i>
											</div>
											<div class="item-inner">
												<div class="item-title label">购买金额&nbsp;&nbsp;*</div>
												<div class="item-input">
													<input type="text" id="share" name="share"
														value="1" placeholder="请输入购买份数"
														class="">
												</div>
												<div class="item-after">
													<label class="label-switch">万元 </label>
												</div>
											</div>
										</div>
									</li>
									<li>
										<div class="item-content">
											<div class="item-media">
												<i class="icon icon-form-password"></i>
											</div>
											<div class="item-inner">
												<div class="item-title label">个人年收入&nbsp;&nbsp;*</div>
												<div class="item-input">
													<input type="text" id="perincome" name="perincome"
														value="${policycach.perincome }" placeholder="请输入个人年收入"
														class="">
												</div>
												<div class="item-after">
													<label class="label-switch"> 万元 </label>
												</div>
											</div>
										</div>
									</li>
									<li>
										<div class="item-content">
											<div class="item-media">
												<i class="icon icon-form-password"></i>
											</div>
											<div class="item-inner">
												<div class="item-title label">家庭年收入</div>
												<div class="item-input">
													<input type="text" id="totalincome" name="totalincome"
														value="${policycach.totalincome }" placeholder="请输入家庭年收入"
														class="">
												</div>
												<div class="item-after">
													<label class="label-switch"> 万元 </label>
												</div>
											</div>
										</div>
									</li>
									<li>
										<div class="item-content">
											<div class="item-media">
												<i class="icon icon-form-gender"></i>
											</div>
											<div class="item-inner">
												<div class="item-title label">开户银行&nbsp;&nbsp;*</div>
												<input type="text" id='bankName' name="bankName"
													value="${policycach.bankName}" placeholder="请输入开户银行" />
												<!-- <div class="item-input">
												<select>
													<option>中国工商银行</option>
													<option>中国农业银行</option>
													<option>中国交通银行</option>
													<option>中国建设银行</option>
													<option>中国光大银行</option>
												</select>
											</div> -->
											</div>
										</div>
									</li>
									<li>
										<div class="item-content">
											<div class="item-media">
												<i class="icon icon-form-password"></i>
											</div>
											<div class="item-inner">
												<div class="item-title label">具体支行&nbsp;&nbsp;*</div>
												<div class="item-input">
													<input id='branch' name="branch" type="text"
														value="${policycach.branch }" placeholder="请输入具体支行"
														class="">
												</div>
											</div>
										</div>
									</li>
									<li>
										<div class="item-content">
											<div class="item-media">
												<i class="icon icon-form-password"></i>
											</div>
											<div class="item-inner">
												<div class="item-title label">银行账号&nbsp;&nbsp;*</div>
												<div class="item-input">
													<input id='cardCode' name="cardCode" type="text"
														value="${policycach.cardCode }" placeholder="请输入银行账号"
														class="">
												</div>
											</div>
										</div>
									</li>
									<li>
										<div class="item-content">
											<div class="item-media">
												<i class="icon icon-form-email"></i>
											</div>
											<div class="item-inner">
												<div class="item-title label">所在省市区&nbsp;&nbsp;*</div>
												<div class="item-input">
													<%-- <input type="text" id='city-picker' name="city-picker"
														value="${policycach.city_picker }" placeholder="请选择所在省市区" /> --%>
													<div data-toggle="distpicker">
														<select data-province="${policycach.province}" name="province"></select>
														<select data-city="${policycach.city}" name="city"></select>
														<select data-district="${policycach.district}" name="district"></select>
													</div>
												</div>
											</div>
										</div>
									</li>
									<li>
										<div class="item-content">
											<div class="item-media">
												<i class="icon icon-form-email"></i>
											</div>
											<div class="item-inner">
												<div class="item-title label">详细地址&nbsp;&nbsp;*</div>
												<div class="item-input">
													<input type="text" id="address" name="address"
														value="${policycach.address }" placeholder="请输入详细地址" />
													<!-- value="江南路1689号浙江大学软件学院" -->
												</div>
											</div>
										</div>
									</li>
									<%-- <li>
										<div class="item-content">
											<div class="item-media">
												<i class="icon icon-form-password"></i>
											</div>
											<div class="item-inner">
												<div class="item-title label">邮编</div>
												<div class="item-input">
													<input type="text" id="letterCode" name="letterCode"
														value="${policycach.letterCode }" placeholder="请输入邮编"
														class="">
												</div>
											</div>
										</div>
									</li> --%>
								</ul>
							</div>
							<!-- <div class="card-footer"></div> -->
						</div>
					</div>
					<div class="content-block">
						<div class="row">
							<div class="col-100">
								<input type="submit" value="下一步"
									class="button button-big button-fill button-success"
									external>
							</div>
						</div>
					</div>
					<%@ include file="/include/footer.jsp"%>
				</form>
			</div>
		</div>
	</div>

	<script src="assets/js/jquery.min.js"></script>
	<script src="assets/js/distpicker.data.js"></script>
	<script src="assets/js/distpicker.js"></script>

</body>
</html>